Provider Demographics
NPI:1730117813
Name:BORGE, LAUREN ELIZABETH (PT)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:BORGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 OLD ROUTE 7
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-1714
Mailing Address - Country:US
Mailing Address - Phone:203-740-0020
Mailing Address - Fax:203-775-0238
Practice Address - Street 1:1001 WATERMAN AVE
Practice Address - Street 2:
Practice Address - City:E PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1314
Practice Address - Country:US
Practice Address - Phone:401-434-1773
Practice Address - Fax:401-435-0500
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02046225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist